Wales’ Future Generations Challenge the World for the “Sitting” Gold Medal

2018Active Healthy Kids WALES Report Card

It’s Time to MOVE the Bottom LineAuthors: Lowri Cerys Edwards, Richard Tyler, Dylan Blain, Anna Bryant, Neil Canham, Lauren Carter-Davies, Cain Clark, Tim Evans, Ceri Greenall, Julie Hobday, Anwen Jones, Marianne Mannello, Emily Marchant, Maggie Miller, Graham Moore, Kelly Morgan, Sarah Nicholls, Chris Roberts, Michael Sheldrick, Karen Thompson, Nalda Wainwright, Malcolm Ward, Simon Williams and Gareth Stratton.

Purpose: This is the third Active Healthy Kids Wales (AHK-Wales) Report Card followingthe inaugural and second report card published in 2014 and 2016 respectively1,2. The 2018report card consolidates and translates research related to physical activity amongchildren and young people in Wales. The report card aimed to raise the awareness ofchildren and young people’s engagement in physical activity behaviours and influences,and advocate for children’s right to be active and healthy.

Methods: The AHK-Wales Research Work Group (RWG) consisted of 24 members, andcomprised of academics, postgraduate researchers, professionals and practitioners withexpertise in physical activity and access to national data sources. Ten physical activityindicators were graded using the harmonized Report Card development processinvolving a synthesis and expert consensus of the best available evidence. The tenindicators included: Overall Physical Activity, Organised Sport Participation, Active Play,Active Transportation, Sedentary Behaviours, Physical Fitness, Family and Peers, School,Community and Environment and Government. In Wales, an additional indicator wasincluded: Physical Literacy. The indicators were evaluated a standardized gradingscheme ranging from A+ (94-100% of children met the criteria), to F (0-19 % meet thecriteria) or Inconclusive (Inc; indicated that data was inadequate or not available) wereused to grade each quality indicator. Data from the following nationally representativesurveys, distributed between 2016-2018, were analysed by the RWG to grade eachindicator: the Health Behaviour in School-Aged Children survey (2017/18)3, NationalSurvey for Wales (2016/17)4, Play Sufficiency Assessment Surveys5 and the Health-Enhancing Physical Activity (HEPA) Policy Audit Tool6.

Results: As illustrated in Table 1, out of the ten grades, twoindicators were graded C+ (Organised Sport Participation andGovernment), one indicator was C- (Active Play), two indicatorswere D+ (Overall Physical Activity and Active Transportation), onewas D (Family and Peers), one was F (Sedentary Behaviours) andthree were inconclusive (Physical Fitness, School and Communityand Environment). Wales’ eleventh indicator: physical literacy, wasalso inconclusive. Overall, there is limited nationallyrepresentative data on children and young people’s physicalactivity and health. There is a lack of evidence on the early years(under 5 years old) in all indicators which is problematic givenphysical activity behaviours develop in early childhood8. Further,grades for each indicator were based on the results of self-reported survey data as opposed to objective measures, forexample accelerometers to measure physical activity. More effortis required to address this gap through systematic robust datacollection methods within schools and in the community. The AHK-Wales RWG recommends that more effort needs to be made togenerate nationally representative data on the AHK indicators andto develop effective approaches that seek to increase children’sphysical activity and decrease sedentary behaviours.

Conclusions: Despite 21 national policies that incorporatestrategies, action plans, legislation and guidance that aim topromote physical activity in children and young people in Wales,children meeting the guidelines for physical activity remains lowand sedentary behaviours remain high. The AHK-Wales RWGurges for (i) a concerted effort to generate more nationallyrepresentative data, and (ii) a redoubling of efforts to createopportunities that will help increase children’s physical activityand decrease sedentary behaviours so that future generationsreceive the lifelong health and developmental benefits of physicalactivity.

References: 1. Stratton G, Williams C, Brophy S, et al. Active Healthy Kids Report Card 2014 – Wales. http://www.swansea.ac.uk/media/AHK-Wales%202014%20final.pdf. Accessed May 5,

2018.2. Tyler R, Mannello M, Mattingley R, et al. Results From Wales’ 2016 Report Card on Physical Activity for Children and Youth: Is Wales Turning the Tide on Children’s Inactivity? J

Phys Act Heal. 2016; 13(11 Suppl 2): S330–6. 3.3. Health Behaviour in School-aged Children Wales Survey 2017/18.https://gov.wales/statistics-and-research/health-behaviour-school-aged-children/?lang=en. Accessed

May 20, 2018. 4. National Survey for Wales 2016/17. https://gov.wales/statistics-and-research/national-survey/?lang=en. Accessed February 20, 2018. 5. Play Sufficiency Assessment Surveys 2016. http://www.playwales.org.uk/eng/sufficiency. Accessed March 19, 2018.6. Health-enhancing physical activity (HEPA) Policy Audit Tool (PAT). http://www.euro.who.int/__data/assets/pdf_file/0006/151395/e95785.pdf. Accessed February 10, 2018.7. Tyler, R. Mackintosh K, Brophy S, et al. Swan-Linx: Fitness Fun Day Report – Swansea Schools 2015. https://www.swansea.ac.uk/media/Swan-

Linx%20Swansea%20Schools'%20Fitness%20Fun%20Day%20feedback%20report%20(2015).pdf. 8. Edwards LC, Bryant AS, Keegan RJ, et al. Definitions, Foundations and Associations of Physical Literacy: A Systematic Review. Sports Med. 2017; 47(3): 113 – 126.9. Edwards LC, Bryant AS, Keegan RJ, et al. ‘Measuring’ Physical Literacy: A Systematic Review of Empirical Findings. Sports Med. 2018; doi: 10.1007/s40279-017-0817-9.10. Active Healthy Kids Wales Web site. http://activehealthykidswales.com. Accessed April 15, 2018.

Indicator Grade RationaleOverall Physical

ActivityD +

18.4% of children and young people aged 11-16 years met the recommendation of at least 60

minutes of MVPA every day of the week; 16.8% children and young people aged 11-16 usually

exercised in their free time every day of the week (Health Behaviour in School-Aged

Children survey [HBSC])3. In another survey, 51% of 3-17 year olds were active for at least an

hour seven days a week (National Survey for Wales [NSW])4. The weighting for this indicator

was as follows: an average of the HBSC data (18.42% and 16.78% = 17.6%) and the NSW data

(51%) was weighted 50/50 resulting in a 34% of 3-17 year olds meeting activity guidelines in

Wales.

Organised Sport

ParticipationC +

55% of children and young people aged 11-16 years took part in organised activities outside

of school/outside of lessons. These children took part in: i. Organised team sport activities

(e.g. football, basketball and volleyball); ii. Organised individual sport activities (e.g. tennis,

gymnastics and karate); iii. Children and youth organisations (e.g. scouting, guides, cadets,

Duke of Edinburgh)3.

Active Play C -41% of children aged 5-17 years reported playing out most days3. In another survey, 44% of

11-16 year olds exercised in their free time during their summer holidays3.

Active

TransportationD +

44% primary school children and 33% secondary school pupils traveled actively to school

(walked with an adult, walked on their own or with other children, cycled)4. In another

survey, 33.8% of children and young people aged 11-16 years walked/cycled to school; 36.1%

children and young people walked/cycled from school3.

Sedentary

BehavioursF

80% of children/young people aged 11-16 years spent 2 or more hours sitting in their free

time (e.g. watching TV, using a computer or mobile phone, travelling in a car or by bus,

sitting and talking, eating and studying) on weekdays and 87% on the weekend3. In another

survey, 81% percent of children had at least two hours screen time on an average weekday

and 92% had at least two hours screen time on a weekend day4.

Physical Fitness Inc.There is a growing dataset of physical fitness measures of children in Wales but there is no

national data covering all components of physical fitness and full age range were available

therefore inconclusive7.

Family and

Peers D

59% of parents were active for 150 minutes+ a week, 8% of parents take part in vigorous

activity for >75 minutes/ week, 31% of parents take their child to the playground and 20% of

parents take part in informal games such as playing Frisbee4.

School Inc.No updated data available for ‘School’ since AHK-Wales 2016 (2016 score: B), therefore

School is inconclusive.

Community and

EnvironmentInc.

No updated data available for ‘Community and Environment’ since AHK-Wales 2016 Report

Card (2016 score: C), therefore Community and Environment is inconclusive.

Government C +21 Policy documents assessed across different sectors including Health, Sport, Education,

Environment, Transport, Urban Design/ Planning, Other (Play, Sustainable Development;

Cross-cutting). Using the HEPA Policy Assessment Tool to evaluate the 21 policies, the

grade for Government was 54%6.

Table 1: Grades and rationales for Wales’ 2018 Report Card.